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Damage Disputes from Both Perspectives

This article follows our recent webinar regarding damage disputes.

What’s the secret to prevailing in a damage dispute? The answer is… there isn’t one! Arbitration disputes have always centered on the premise that each company will both argue and support its case. The decision is then made based on the arbitrator’s evaluation of the arguments and evidence presented, given the preponderance of evidence standard.

While there aren’t any secrets to prevailing in a damage dispute, there are some considerations to keep in mind whether arguing the dispute as an Applicant or a Respondent. First, the obligation of a first-party carrier to its insured is greater than the obligation of a third-party carrier to a claimant, because there is a direct contract between the parties. This difference in obligation, along with other factors like additional coverage endorsements, the desire to retain the customer, and state laws specific to first-party carriers, can impact what an insurer pays to its policyholder.

If filing as an Applicant, remember that the Respondent will always seek to limit its payment to only damages for which its insured is legally liable. For example, if the claim involves circumstances that extend the duration of payments, such as storage and rental, explain the circumstances and provide supporting evidence. Did the date of loss precede a long holiday weekend? Was the insured owner seriously injured, delaying the total loss claim process? Did the occurrence happen during a major weather event that caused a backup in local repair shops?

If disputing damages as a Respondent, remember to state the disputed dollar amounts and the arguments in the Damage Dispute area per Rule 2-5. Damages argued in any other area will not be considered by the arbitrator. Ensure your arguments are specific and supported with evidence. For example, if arguing the duration of rental, provide an alternative number of days for which the insured would be legally liable, along with an explanation.